My experiences of the privatised NHS
Over the past few years I have experienced changes in the way NHS services are being delivered in Southampton with some private companies being awarded NHS franchises. Some of the changes may be for the better but there are also problems that are seemingly being brushed under the carpet.
Over the past few years, my local GP practice has changed a couple of times. It was amalgamated with another practice and, although retaining its original name, the second venue, being a newer and better equipped building, became the administrative centre for them both. They are now run by a “hidden” private company and a third practice has been added.
There were some advantages with the same doctors working in all three centres, although the last of those three no longer acts as a GP surgery. The original practice had had the worst record in the city but recently it has become one of the best but let’s see what has improved.
A few years ago, to get an appointment meant the “Monday morning 8 o’clock rush” when the best way of attempting to get an appointment meant queuing outside the surgery entrance at 8:00 a.m. on a Monday morning and being lucky to get an appointment for a few weeks hence. It was impossible to get through on the telephone and if you did, after negotiating the selection system to identify your need, you had to hold for ages – so long that the line would often be dropped requiring a fresh attempt. They did, however, introduce an on-line booking system which few people knew about or used. Initially I found it was great. It showed the slots available for each doctor and I could book online for whom I wanted to see at a time that suited me. However, that didn’t last long. I guess as more and more people found out about the service, it was changed with fewer and fewer bookable slots being shown and usually for doctors I had never previously heard of. It was soon dropped altogether and, despite the present government’s assertion that all GP surgeries can now take online bookings, mine can’t. They did, however, advertise private blood tests and physio appointments though they have been removed.
Recently, however, telephone booking has become much easier. The last couple of times I have needed an appointment, I have got straight through to the receptionist and, after explaining why I needed to see a doctor, in each case was given an appointment later that same day! Granted, it may have been because each time there may have been some major issue which they deemed urgent.
One of those appointments was regarding symptoms that may have indicated cancer. Although the doctor who saw me just a couple of hours later assured me it probably wasn’t, I was referred the same day for a test at the general hospital. So good, right? – Well that’s where the practice is not so good.
I had the hospital tests and was told the results would be with my GP within a couple of days. Well, a couple of weeks later, I had heard nothing so I began an online search. Should I try the hospital’s online portal or the GP’s?
The hospital portal is good. Although it can take a few days for documents to be uploaded, they are entire and I get an email notification of a new addition to my notes. They are usually in “doctorese” but I have sufficient medical knowledge to manage that. My test results weren’t there.
After interrogating and navigating a none-too-easy GP portal, I found there was a mention of my hospital test and when I opened it, it was just the doctor’s note saying “no further action required.” It took more searching to find an obscure link that provided the information that the test was negative for cancer. So I am finally assured it is not cancer but the GP practice should have informed me and I’m assuming they are not interested in finding out what the cause of the symptoms was.
With chronic back pain which I knew was osteoarthritis, I eventually saw the GP. Though they wanted me to just see their physiotherapist, I insisted I wanted to see a doctor who sent me for an X-ray. Hearing nothing and in intense pain, I actually took myself to A&E which is something I would never have done usually. There I learned my X-ray results and the nurse said she would print off the report for me if I wanted but found her system wouldn’t let her. I checked the surgery website to find the entry regarding my x-ray which just said 3 words: “Right hip worst.” They then referred me to the practice physiotherapist who said there was nothing wrong with my x-rays. I said I hadn’t seen the report and he said he’d email it to me – which never happened. Instead he emailed me a bunch of back exercises to do daily and prescribed ibuprofen and co-codamol despite my saying I mustn’t take NSAIDs because of my gastric problems and that codeine gives me horrendous stomach cramps. He relented and provided amitriptyline which did nothing so he gave me opioid patches, which are working to a degree, saying if that didn’t help he’d arrange steroid injections which I don’t want. Apart from that first visit, I haven’t seen him again, just a couple of phone consultations but he did send me to the privatised/franchised physio service he is part of who did show me a healthy x-ray. Whether it was actually mine, I don’t know. After scrupulously following the prescribed exercises for months, I realised they were making me worse and I stopped them to let my back recover.
More recently I developed a shoulder problem. I downloaded some exercises from the NHS site which told me to contact my GP if I saw no improvements within a couple of weeks, which I did. I was seen by a young female trainee physio who, although being very sweet and perfectly professional, just gave me the standard advice: ice, ibuprofen as if I’d been born yesterday. She spoke with the physiotherapist who emailed me a raft of exercises, none of which helped but those that I had already been following, though not in that bundle, did.
I ave never had any follow up since the exercises and drugs were prescribed.
When I first came to Southampton 25 years ago, we had two main NHS hospitals. To streamline services, most of the departments were transferred to the General Hospital’s site, the other hospital was given a bit of a facelift before selling it off to a private healthcare trust operating under the NHS flag. They have transformed much of the building to make it appear more welcoming and a nicer environment but that doesn’t necessarily extend to the service.
During the COVID pandemic, to keep the General hospital infection free, much work was farmed out to the franchised unit. I was due to have a minor surgical treatment for my prostate which I was assured would be under general anaesthetic and require an overnight stay but it was to be carried out at the second hospital.
I arrived on the morning with an overnight bag to learn they would not be keeping me overnight but that I would need to come back the next day.
The surgery was not carried out by a full anaesthetic but by a spinal injection that completely numbed my lower body.
I was left to recover afterwards in a small crowded side ward with minimal privacy.
A bit after five o’clock, I was asked if I could get up and dress. The feeling in my legs was only just beginning to return. The nurse offered me no assistance but I saw her nose wrinkle and in a voice of disgust ask, “Do you do that often?” I hadn’t realised but with the absence of any muscular control below the waste I had messed myself. She disappeared and returned with a small pack of wet wipes and a plastic bag to put them in.
I phoned my wife to collect me. As I left (complete with an attached catheter), all the nursing staff were also leaving as it was the end of the day. I got the impression, confirmed the next day, that they work strictly by hours rather than patient need.
The next day I returned to have the catheter removed. TWOC (Trial WithOut Catheter) they call it. I was put in a very shabby side room with an en suite. It was obvious that this had had no facelift. I had to collect any urine I passed and was given a lot of water which I was drinking continuously. At midday I was brought a very dry sandwich (nothing like the fantastic meals the General Hospital provides).
Although by 5 o’clock it was obvious I had not passed enough urine to pass the TWOC, they decided to discharge me anyway (as it was their home time). The discharge papers just provided the bald fact that the surgery had been done and the space for follow up clinic had been crossed through.
It took a few painful weeks before things were normal.
There has never been any follow up.
Of course dentistry was the first NHS service to be privatised and, although they’re meant to provide NHS services insufficient do.
I don’t like dentists and only visit if necessary.
I received a threatening text from the practice I am signed up with saying if I didn’t visit for a checkup before a particular date, I would be removed from their NHS list, so I gritted my teeth and went.
The waiting room was plastered with adverts for dental health services. “Good News. We now provide xxx service for just £xxx!”
I told the receptionists, of whom there seemed an abundance, that I didn’t really like dentists as I only experienced tooth pain after visiting the dentist. They laughed as if I was telling a joke!
The dentist looked and prodded and asked if I had had any pain. I did say I had ad some heat intolerance in one of my teeth recently. That is something I occasionally get with any of my teeth when I have something cold like ice cream. It’s not that unusual but he was adamant that I would need an x-ray (at an extra charge of course). At that session, he said the x-ray showed a shadow: that the tooth was rotten and needed to come out. I could not see any shadow on the x-ray.
So I returned the next day for an extraction. I was in the chair for an hour and a half as he tried in vain to pull it out and finally succeeded in breaking it off leaving me in chronic, extreme pain and telling me I would hear from the hospital who would complete the job. Not hearing anything within a week and still being in intense agony, I eventually found out that the “hospital” was another dental practice who told me, “Good News. We will be able to see you in 2 months’ time!” Unwilling to endure the pain that long, I had it done privately at enormous cost. I had also been billed by the original dentist for the checkup, the x-ray visit and the failed extraction (even though the latter two should have only been one payment). I complained and the practice has permitted me to remain on their books but that I will only visit them if I actually do have a problem.
To this day, I do not believe that tooth was rotten.
This isn’t actually my story but about my wife’s experiences.
Opticians now provide eye testing for NHS, making their profits from spectacle sales but their optometrists can diagnose other problems, too.
My wife’s optician was concerned when he examined her eyes. He agreed she was developing cataracts, which are not uncommon in ageing bodies, and recommended she would need surgery but that due to particularly thin membranes, it would need to be carried out at the hospital rater than the privatised/NHS franchised group he was attached too and referred her to the GP to make the referral.
However, the GP, following the latest guidelines, sent her to the private group instead. They agreed she needed a corneal scrape and polish first for which she needed a hospital appointment so she was again referred back to the GP. The delay caused by this amounted to a whole year lost during which her eyesight was further deteriorating and risking permanent sight loss.
With the “success” of handing over eye tests to private opticians, a similar action has happened for hearing loss with hearing testing advertised regularly on television along with the idea of cheap hearing aids – but “cheap” doesn’t mean “free” which can be provided by NHS.
My hearing has always been below par. I know it is due to years of extra-oesophageal reflux – an area in which I have become an expert.
It was my wife commenting on how I was needing the TV volume on higher and greater reliance on subtitles that drove me to having a hearing test by one of the chains of opticians whose adverts I would see.
The hearing test was quite thorough confirming I had profound hearing loss but that they couldn’t do any more as my GP surgery was not signed up to their service so I had to see my doctor. He referred me to a privatised NHS franchise who retested my ears (not as thoroughly) and agreed my hearing loss was noticeable and I needed hearing aids which I could have under the NHS but they first sent me to one of their ENT doctors. (Although they referred to him as a “doctor,” I am doubtful about his qualification.)
The ENT doctor was an American. He doubted my hearing loss was significant and suggested it must be due to Eustachian Tube Dysfunction. (Having had this all my life, I have previously been tested over the years for this. When I was 6, after having had my ears syringed weekly to no avail, I had had my tonsils and adenoids removed in case they were causing the problem. It was only from my own studies forty years later that I discovered it was reflux that had caused my problems. Now seventy years later, this “doctor” wanted to requestion the causes despite my having been examined for ETD a few times during my life. He told me categorically that reflux doesn’t affect the ears despite my having found numerous papers confirming it and had data from surveys of hundreds of refluxers I had conducted myself.
Instead of prescribing hearing aids, he prescribed a NeilMed sinus rinse, “Not available on NHS,” which I should have realised sounded an alarm. It was exorbitantly expensive for a cheap squeezy bottle and a few sachets of salt to mix with purified water I would have to provide. I told him a previous ENT doctor had taught me to flush my sinuses by cupping tap water and snorting it. He responded by saying he thought I needed the “isotonics.” That’s when I knew he was a quack. I taught science for nearly 30 years. Unlike him, it appeared, I knew what the term meant. He also said their was a technique that divers were taught to clear their sinuses. I didn’t tell him I had trained as a diver in a club fifty years ago and had learned the valsalva manoeuver. (Although I passed all the most advanced grades of my British Sub Aqua Club training, the one section I failed on was not gaining a medical certification on my ears because of te damage done by syringing as a child.)
I complained to the company under which this charlatan practised and was provided with a new consultation with a better ENT doctor. He was excellent. He agreed the hand cupping sinus rinse technique I had been taught was adequate and explained to me how reflux affects the ears (almost verbatim for the text I had written in an article about it). He also said the weekly syringing had caused my eardrums to become concave and partially fused the ossicles of the middle ear. He asked about tinnitus which I have constantly and grown used to. Although he would have referred me to see if they could treat it, he agreed with me that, since I had learnt to live with it, it was probably better to ignore it. He had no hesitation providing me with hearing aids free under the NHS which I now enjoy. They don’t stop the constant hiss of my tinnitus but do mask the rumbling type that I also have when my hearing aids are removed.
There has been no follow up to see if any adjustments are required.